The human costs of the wars in Afghanistan and Iraq were on full display in the Senate Veterans’ Affairs Committee on Thursday when an Iraq veteran explained, haltingly, how he only got care for post-traumatic stress disorder after he attempted suicide.

An Army infantryman and biochemist who was injured by an improvised explosive device during his first deployment to Iraq in 2003 explained that after being told he was suffering from anxiety and “readjustment issues” by caregivers at a Fort Hood clinic and placed on a six-month wait list to see a psychiatrist, he fell into despair.

Daniel Williams explained that in the winter of 2004 he locked himself in his bathroom, took out his .45 and shoved it into his mouth. His former wife Carol called the police.

“When the police arrived I argued with them. When they kicked open the door I pulled the trigger, but by the grace of God the weapon misfired,” Williams said. When one of the officers tried to clear the weapon it went off, but Williams said no one was hurt.

Williams is one of 187,133 veterans diagnosed with PTSD, according to the latest data from the Government Accountability Office.

Williams was finally admitted to an on-base hospital but said the Army violated his privacy by telling his platoon sergeant about his treatment. She “then proceeded to tell my fellow soldiers” who “looked down on me” and questioned his professionalism, he said.

“We’re taught how to be soldiers, not civilians,” he said, and “once we’re put out, we’re hung out to dry.”

He testified that in order to get care after he was discharged from the Army, he had to be arrested by Veterans Affairs police. “People are talking on their cellphones, telling me to wait,” he said, describing the bureaucratic hassles he faced as he tried to get care.

Community outreach to vets needs to be improved by the VA, Williams said. The current system “makes you want to give up.” There needs to be better communication to vets about treatment opportunities. Peers who have been in the military and in combat need to step forward and help their brothers and sisters, Williams said. He said the National Association on Mental Illness is partnering with the VA to help families understand why vets are “doing the things they’re doing.”

“There is a mental health crisis,” said Andrea Sawyer, the spouse of an Army vet with severe depression and chronic PTSD. Sawyer explained how her husband, Army Sgt. Loyd Sawyer, spiraled into depression after extended service in mortuary services in Dover, Del., and in Iraq. She said the treatment provided by the Army and by the VA to her husband was riddled with “gaps” and “disconnects,” which is the result of the government’s “largely-passive approach to outreach.”

“It’s really a broken system,” she said. “It almost takes — pardon the pun — an act of Congress” to get treatment, she said.

Sawyer, a former teacher, said that she was confronted by her principal who said she had a choice: her job or her husband. She testified that she made the only possible choice she could.

“I gave up my job, in order to keep him alive. That’s what I had to do,” she said. “Quite honestly I feel that I’m the captain of the team: I monitor symptoms, I see the decrease in his quality of life and at that point I activate the chain [of command]. … I do everything I can.”

Treating physicians don’t understand the military culture and the combat experience of their patients, Sawyer told the committee, urging senators to take action to develop a “truly transformative veteran-centered approach to the VA mental health care."

And when it was time for the VA to explain what it had done to deal with the wave of vets suffering from depression and PTSD, there was some clear frustration.

“How do you define timely [treatment] for a veteran with a gun in his mouth?” Sen. Richard Burr (R-N.C.) asked William Schoenhard, the deputy undersecretary for health operations and management at the VA.

Burr was less than satisfied by the responses. “Your opening statement … I heard it before, I just hadn’t heard it from you,” Burr explained, his voice booming.

“Please understand it does not work. There are gaps; there are holes. There are veterans who are falling through the gaps … and there are professionals who really didn’t give a damn,” Burr said as Sawyer and Williams nodded vigorously in the hearing room.

“I fear that your definition of timely and the frontline definition of timely is different. It is ‘whenever I have time to deal with it,’” Burr said

“How could it be that the VA wasn’t prepared for this?” Senate VA committee Chairman Patty Murray (D-Wash.) asked VA officials during the hearing.

“We were not as quick as we should have been and we’re going to learn from this,” Schoenhard said. “We can do better and we will do better,” he pledged.

“One suicide is one too many,” he said.

Schoenhard said there have been 15,000 “rescues” of veterans who threatened suicide since a crisis line was established in 2007.

Given the staffing issue the VA faces, leadership needs to establish arrangements with doctors that go far beyond payment, John Daigh, a psychiatrist, and an assistant inspector general for health care inspections told the committee. Medical records need to be shared and VA leadership needs to think outside of the box.

“Where VA doesn’t have primary-care outposts — which is a large part of the country — VA needs to sit down and talk with local leaders … to pool resources to take care of individuals where they live,” Daigh recommended.

“At this point, we need people treating patients,” Sawyer said in answer to questions by Sen. Scott Brown (R-Mass.).

Brown summed it all up this way, telling Schoenhard: “You need to get a handle on this or you will be back here every week.”

Dealing with the sexual assault of women veterans is a priority for Murray, who was incredulous when told that the VA doesn’t have a definition of this type of assault. “Ask any woman and she’ll tell you,” Murray said.

Murray ordered the VA to make the reports of sexual assaults of women vets a priority and to complete an immediate, systemwide review of wait times for vets seeking treatment. Murray said she isn’t confident that the 14-day number to get a first appointment with the department is real.

Murray told POLITICO that Williams’s testimony was “heartbreaking” and sent a clear message to the VA: The department “needs to get out of its comfort zone when it comes to PTSD and to address this because of the real concerns, internally, that they are not meeting the needs of our veterans. I hope this hearing sent that message loud and clear.”

This article first appeared on POLITICO Pro at 2:58 p.m. on July 14, 2011.